pharm chapter 3, 4

side effect categories

1. dermatological 2. stomatitis (mucus membrane) inflammation/damage 3. superinfections (from destruction of normal flora) 4. blood dyscrasia - bone marrow suppression 5. toxicity 6. renal impairment 7. hyper/hypoglycemia 8. electrolyte imbalances 9. sensory/auditory damage 10. CNS damage 11. teratogenicity

key elements of drug education

1. name, dose, action of drug 2. timing of administration 3. special storage/administration 4. OTC/alternative to avoid 5. special comfort measures 6. safety measures 7. specific points about toxicity 8. warnings about discontinuing drugs

kidneys and drugs

An elevated creatinine level is indicative of diminished kidney function, which will result in serum drug toxicity. The creatinine level indicates kidney function, does not affect absorption, and has no effect on gastric emptying. Idiosyncratic effects are reactions that occur rarely and unpredictably among the population.

The nurse is assessing a diverse group of clients, all of whom are being treated with medications. Which clients are experiencing adverse effects related to the primary actions of their medications? 1. a client whose diuretic causes episodes of dizziness 2. a client whose benzodiazepine causes sedation 3. a client who experiences nausea after taking an oral antibiotic 4. a client who finds that a hypnotic causes an unpleasant metallic taste 5. a client whose vitamin B supplement changes the color of his urine

Diuretics lower blood pressure, which can lead to dizziness. Benzodiazepines depress the central nervous system, causing sedation. In both cases, the adverse effect is an extension of the intended effect; these are examples of adverse effects resulting from primary actions. In contrast, each of the other clients are experiencing adverse effects related to secondary actions, since nausea, unpleasant tastes and urinary changes are not extensions of each drug's intended effects.

Hypersensitivity reactions

Excessive response to primary or secondary effect of drug

7 rights of medication administration

Right drug, right dose, right patient, right route, right time, right reason, right documentation, right storage, right prep

cytotoxic drug reaction

antibodies in blood attack cells with drug antigens attached

3 types of nursing interventions in drug therapy

drug admin - IM or IV provision of comfort measures patient/family education

primary drug reaction

extension of expected result (coag, bleeding, sedation)

drug allergy & reactions

formation of antibodies to a drug or drug protein; causes an immune response when the person is next exposed to that drug 4 reactions: 1. anaphylactic 2. cytotoxic 3. serum sickness 4. delayed reactions

"Evaluation" of the client's response to drug therapy relates most closely to which phase of the nursing process? 1. Problem 2. Goal 3. Plan 4. Cause

goal. The effectiveness of the interventions to address the goal occurs in the evaluation phase of the nursing process. Once the problem is identified, the goal and plan are established.

assessment 2 important aspects

history (PMH) and exam (PE)

implementation

nursing interventions aimed to reach goals

types of drug reactions

primary, secondary, hypersensitivity

secondary drug reaction

side effects